AHIP FINAL EXAM NEWEST 2025-2026 VERSION QUESTION
WITH GOLDEN
TIPS SOLUTIONS AND REVIEWS
1. Mr. Wu is eligible for Medicare. He has limited financial resources
but failed to qualify for the Part D low-income subsidy. Where might
he turn for help with his prescription drug costs?:ANSWER Mr. Wu may still qualify
for help in paying Part D costs through his State Pharmaceutical Assistance Program.
2. Mr. Bauer is 49 years old, but eighteen months ago he was
declared dis- abled by the Social Security Administration and has
been receiving disability payments. He is wondering whether he can
obtain coverage under Medicare. What should you tell him?: ANSWER After
receiving such disability payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age.
3. Mildred Savage enrolled in Allcare Medicare Advantage plan
several years ago. Mildred recently learned that she is suffering from
inoperable cancer and has just a few months to live. She would like
,to spend these final months in hospice care. Mildred's family asks you
whether hospice benefits will be paid for under the Allcare Medicare
Advantage plan. What should you say?: ANSWER Mildred may remain enrolled
in Allcare and make a hospice election. Hospice benefits will be paid for by Original Medicare under
Part A and Allcare will continue to pay for any non-hospice services.
4. Mr. Schmidt would like to plan for retirement and has asked you
what is covered under Original Fee-for-Service (FFS) Medicare. What
could you tell him?: ANSWER Part A, which covers hospital, skilled nursing facility, hospice,
and home health services and Part B, which covers professional services such as those provided by
a doctor are covered under Original Medicare.
5. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry
is cur- rently enrolled in Medicare Parts A and B. Jerry has also
purchased a Medicare Supplement (Medigap) plan which he has had
for several years. However, the plan does not provide drug benefits.
How would you advise Agent John Miller to proceed?: ANSWER Tell prospect
Jerry Smith that he should consider adding a standalone Part D prescription drug coverage policy
to his present coverage.
6. Mr. Davis is 52 years old and has recently been diagnosed with
,end-stage renal disease (ESRD) and will soon begin dialysis. He is
wondering if he can obtain coverage under Medicare. What should
you tell him?: ANSWER He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
, 7. Mr. Diaz continued working with his company and was insured
under his employer's group plan until he reached age 68. He has
heard that there is a premium penalty for those who did not sign up
for Part B when first eligible and wants to know how much he will have
to pay. What should you tell him?: ANSWER Mr. Diaz will not pay any penalty because
he had continuous coverage under his employer's plan.
8. Madeline Martinez was widowed several years ago. Her husband
worked for many years and contributed into the Medicare system. He
also left a substan- tial estate which provides Madeline with an
annual income of approximately
$130,000. Madeline, who has only worked part-time for the last three
years, will soon turn age 65 and hopes to enroll in Original Medicare.
She comes to you for advice. What should you tell her?: ANSWER You should tell
Madeline that she will be able to enroll in Medicare Part A without paying monthly premiums
due to her husband's long work record and participation in the Medicare system. You should also tell
Madeline that she will pay Part B premiums at more than the standard lowest rate but less than the
highest rate due her substantial income.
WITH GOLDEN
TIPS SOLUTIONS AND REVIEWS
1. Mr. Wu is eligible for Medicare. He has limited financial resources
but failed to qualify for the Part D low-income subsidy. Where might
he turn for help with his prescription drug costs?:ANSWER Mr. Wu may still qualify
for help in paying Part D costs through his State Pharmaceutical Assistance Program.
2. Mr. Bauer is 49 years old, but eighteen months ago he was
declared dis- abled by the Social Security Administration and has
been receiving disability payments. He is wondering whether he can
obtain coverage under Medicare. What should you tell him?: ANSWER After
receiving such disability payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age.
3. Mildred Savage enrolled in Allcare Medicare Advantage plan
several years ago. Mildred recently learned that she is suffering from
inoperable cancer and has just a few months to live. She would like
,to spend these final months in hospice care. Mildred's family asks you
whether hospice benefits will be paid for under the Allcare Medicare
Advantage plan. What should you say?: ANSWER Mildred may remain enrolled
in Allcare and make a hospice election. Hospice benefits will be paid for by Original Medicare under
Part A and Allcare will continue to pay for any non-hospice services.
4. Mr. Schmidt would like to plan for retirement and has asked you
what is covered under Original Fee-for-Service (FFS) Medicare. What
could you tell him?: ANSWER Part A, which covers hospital, skilled nursing facility, hospice,
and home health services and Part B, which covers professional services such as those provided by
a doctor are covered under Original Medicare.
5. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry
is cur- rently enrolled in Medicare Parts A and B. Jerry has also
purchased a Medicare Supplement (Medigap) plan which he has had
for several years. However, the plan does not provide drug benefits.
How would you advise Agent John Miller to proceed?: ANSWER Tell prospect
Jerry Smith that he should consider adding a standalone Part D prescription drug coverage policy
to his present coverage.
6. Mr. Davis is 52 years old and has recently been diagnosed with
,end-stage renal disease (ESRD) and will soon begin dialysis. He is
wondering if he can obtain coverage under Medicare. What should
you tell him?: ANSWER He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
, 7. Mr. Diaz continued working with his company and was insured
under his employer's group plan until he reached age 68. He has
heard that there is a premium penalty for those who did not sign up
for Part B when first eligible and wants to know how much he will have
to pay. What should you tell him?: ANSWER Mr. Diaz will not pay any penalty because
he had continuous coverage under his employer's plan.
8. Madeline Martinez was widowed several years ago. Her husband
worked for many years and contributed into the Medicare system. He
also left a substan- tial estate which provides Madeline with an
annual income of approximately
$130,000. Madeline, who has only worked part-time for the last three
years, will soon turn age 65 and hopes to enroll in Original Medicare.
She comes to you for advice. What should you tell her?: ANSWER You should tell
Madeline that she will be able to enroll in Medicare Part A without paying monthly premiums
due to her husband's long work record and participation in the Medicare system. You should also tell
Madeline that she will pay Part B premiums at more than the standard lowest rate but less than the
highest rate due her substantial income.
